A recent article in MedPage commented about the future prospect of accountable care organizations (ACOs). These advanced payment models (APMs) have allowed physicians and hospitals to take on risk and share in any cost savings that may result from meeting financial and quality reporting targets.

Medicare’s ACOs saved more than $1 billion last year, and now some members of Congress are pushing for changes that they say will boost ACOs’ staying power. Given the partisan divide in Congress this may be a difficult effort until after the election.

ACOs are groups of doctors, hospitals, and/or other healthcare providers that work together with a goal of providing better care at a lower cost. Payments to ACOs — including bonuses — are based on their ability to hit certain financial targets set by the program.

To earn the 5% bonus, clinicians must meet thresholds based on the percentage of their patients participating in the ACO. The thresholds, which were set by Congress, increase every 2 years and the 2021 threshold is currently at 75%, a number that the National Association of ACOs (NAACOS) calls “unrealistic.” A survey conducted by NAACOS of 216 respondents found that 96% would be unable to meet the 2021 thresholds.

We have had direct experience in managing a Medicare ACO. These models provide significant clinical benefits to patients while reducing costs for the Medicare program.

ACOs need more time and flexibility to meet the 2021 patient participating threshold. Congress needs to legislate changes in the law that will allow ACOs to continue as a model providing improved clinical care and reducing the costs of care.